{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:06Z","timestamp":1787755566073,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We report a case of a 77-year-old man, with bilateral below-knee amputee, in whom the anterior approach (AA) for a left total hip arthroplasty was used successfully, with 3-year follow-up. This report also summarizes the key studies in the literature on this subject.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The utility of AA surgery performed in the setting of bilateral below-knee amputation has not been previously described. We describe the surgical technique, including considerations and pearls in the amputee population, and particular technical tips related to the use of a fracture table and thin-wire femoral traction for optimum control of the residual limb.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.20.00438","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T16:02:11Z","timestamp":1608825731000},"page":"e20.00438","source":"Crossref","is-referenced-by-count":3,"title":["Surgical Technique for Anterior Approach for Total Hip Arthroplasty After Bilateral Below-Knee Amputation"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7973-221X","authenticated-orcid":false,"given":"Mustafa","family":"Mahmood","sequence":"first","affiliation":[{"name":"Southern Illinois University School of Medicine, Springfield, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1890-7244","authenticated-orcid":false,"given":"Linsen T.","family":"Samuel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9214-2756","authenticated-orcid":false,"given":"Atul F.","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"1","key":"bib1-20230720","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s12891-018-2385-z","article-title":"Effect of surgical approach for contralateral side hip arthroplasty in below knee amputees: a retrospective cohort study","volume":"20","author":"Cho","year":"2019","journal-title":"BMC Musculoskelet Disord."},{"issue":"3","key":"bib2-20230720","first-page":"63","article-title":"Primary total hip replacement for a femoral neck fracture in a below-knee amputee","volume":"6","author":"Masmoudi","year":"2016","journal-title":"J Orthop Case Rep."},{"issue":"4","key":"bib3-20230720","doi-asserted-by":"crossref","first-page":"659.e1","DOI":"10.1016\/j.arth.2009.03.011","article-title":"Technique for total hip arthroplasty in a patient with through-knee amputation","volume":"25","author":"Pekmezci","year":"2010","journal-title":"J Arthroplasty."},{"key":"bib4-20230720","first-page":"38","article-title":"Total hip arthroplasty and rehabilitation in ambulatory lower extremity amputees\u2014a case series","volume":"25","author":"Nejat","year":"2005","journal-title":"Iowa Orthop J."},{"issue":"1","key":"bib5-20230720","doi-asserted-by":"crossref","first-page":"38","DOI":"10.5312\/wjo.v7.i1.38","article-title":"Direct anterior total hip arthroplasty: literature review of variations in surgical technique","volume":"7","author":"Connolly","year":"2016","journal-title":"World J Orthop."},{"key":"bib6-20230720","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s11999.0000000000000112","article-title":"John Charnley Award: randomized clinical trial of direct anterior and miniposterior approach THA: which provides better functional recovery?","volume":"476","author":"Taunton","year":"2018","journal-title":"Clin Orthop Relat Res."},{"key":"bib7-20230720","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.2147\/JPR.S166058","article-title":"In-hospital outcomes with anterior versus posterior approaches in total hip arthroplasty: meta-analysis of randomized controlled trials","volume":"11","author":"Miller","year":"2018","journal-title":"J Pain Res."},{"issue":"2","key":"bib8-20230720","doi-asserted-by":"crossref","first-page":"94","DOI":"10.5312\/wjo.v7.i2.94","article-title":"Direct anterior total hip arthroplasty: comparative outcomes and contemporary results","volume":"7","author":"Connolly","year":"2016","journal-title":"World J Orthop."},{"issue":"4","key":"bib9-20230720","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1016\/j.arth.2017.11.011","article-title":"Does surgical approach affect outcomes in total hip arthroplasty through 90 days of follow-up? A systematic review with meta-analysis","volume":"33","author":"Miller","year":"2018","journal-title":"J Arthroplasty."},{"issue":"3","key":"bib10-20230720","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/17453674.2018.1438694","article-title":"Influence of surgical approach on complication risk in primary total hip arthroplasty","volume":"89","author":"Miller","year":"2018","journal-title":"Acta Orthop."},{"key":"bib11-20230720","doi-asserted-by":"crossref","first-page":"145","DOI":"10.2147\/CEOR.S196545","article-title":"Ninety-day postoperative cost in primary total hip arthroplasty: an economic model comparing surgical approaches","volume":"11","author":"Miller","year":"2019","journal-title":"Clin Outcomes Res."},{"issue":"2","key":"bib12-20230720","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1080\/13696998.2017.1393428","article-title":"Medical resource utilization and costs for total hip arthroplasty: benchmarking an anterior approach technique in the Medicare population","volume":"21","author":"Kamath","year":"2018","journal-title":"J Med Econ."},{"issue":"9","key":"bib13-20230720","doi-asserted-by":"crossref","first-page":"595","DOI":"10.5435\/JAAOS-22-09-595","article-title":"Direct anterior approach for total hip arthroplasty: indications, technique, and results","volume":"22","author":"Post","year":"2014","journal-title":"J Am Acad Orthop Surg."},{"issue":"4","key":"bib14-20230720","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.artd.2019.10.004","article-title":"Algorithmic soft tissue femoral release in anterior approach total hip arthroplasty","volume":"5","author":"Chughtai","year":"2019","journal-title":"Arthroplast Today."},{"issue":"4","key":"bib15-20230720","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1191\/026921598672367610","article-title":"Association between amputation, arthritis and osteopenia in British male war veterans with major lower limb amputations","volume":"12","author":"Kulkarni","year":"1998","journal-title":"Clin Rehabil."},{"issue":"3","key":"bib16-20230720","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1136\/ard.37.3.252","article-title":"Bone and joint changes in lower limb amputees","volume":"37","author":"Burke","year":"1978","journal-title":"Ann Rheum Dis."},{"issue":"3","key":"bib17-20230720","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.apmr.2008.08.220","article-title":"The prevalence of osteoarthritis of the intact hip and knee among traumatic leg amputees","volume":"90","author":"Struyf","year":"2009","journal-title":"Arch Phys Med Rehabil."},{"issue":"5","key":"bib19-20230720","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.aott.2018.06.014","article-title":"Mid-to long-term results of total hip arthroplasty after contralateral lower extremity amputation","volume":"52","author":"Cho","year":"2018","journal-title":"Acta Orthop Traumatol Turc."},{"issue":"9","key":"bib20-20230720","doi-asserted-by":"crossref","first-page":"2919","DOI":"10.1016\/j.arth.2018.04.032","article-title":"Clinical outcomes of patients with lateral femoral cutaneous nerve injury after direct anterior total hip arthroplasty","volume":"33","author":"Patton","year":"2018","journal-title":"J Arthroplasty."},{"issue":"2","key":"bib21-20230720","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1080\/03093640802015953","article-title":"Ipsilateral total hip arthroplasty in a dysvascular below-knee amputee for advanced hip osteoarthritis: a case report and review of the literature","volume":"32","author":"Mak","year":"2008","journal-title":"Prosthet Orthot Int."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.20.00438","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:28Z","timestamp":1787751868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.20.00438"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.20.00438","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]}}}